Group Process

by Tory Butterworth

There's a lot of things that you need to learn to be a therapist. You need to be able to assess people as to the type of problem they have and how bad it is. You need to be able to find ways to talk to people about their problems that allow them to feel comfortable and safe enough to discuss the things they wouldn't outside the room, and yet not so comfortable that they never "get down to business." You need to have some sort of understanding of what makes people better, and the pitfalls which keep clients from getting there.

There are any number of different ways to do therapy, and different therapists do things quite differently. Yet, when I get together with a group of therapists, there does seem to be (at least) one commonality in all our differences. It's the concept of "process," that the way people act in a therapy session tells you as much about them as what they are saying ("content.")

I'm not just trained in the process of a one-on-one therapy session. My degree is in organizational psychology (read, "psychology of organizations," not "psychology of organizing things.") Because of this, I look at the way groups interact and decisions unfold in organizations. One of my client's used to talk about getting a, "bird's eye view" on life. That's the way I think of it: looking at the big picture of how things get done in an organization.

The therapists in the unit down the hall from my office are having some problems. There's a "partial hospitalization program" where patients come 3 to 6 days a week. The building just behind us houses a live-in "respite" program, for clients who need extra help to stay out of the hospital. Those clients live together and eat together, and come over as a group to attend the partial hospital program.

As you might imagine, the respite clients can change the process in the partial hospitalization program. Some days they make up half the people there. That's where I come in. I organized a role play with the staff on this unit, to give them the "feel" of how the group process has changed. I gave half of them a big green "D" to wear around their necks, and asked two of the supervisors to lead them in a group-building activity. The non-Ds I asked to stand out in the hall, and invited them back into the room one by one.

It was easy to create the phenomenon of feeling isolated as a non-D in the "D" group. It was so powerful, in fact, that when I reversed roles, asking the "D" group to stand out in the hall, the non-Ds weren't really able to coalesce as a group. A pretty powerful effect, to have occurred after 15 minutes of role play!

I've been thinking how designing role plays is similar to writing fiction. Most of us get our ideas, in one way or another, from real life, and we condense them into a plot and theme for our novel. Then, we have to figure out how to represent these ideas in the form of characters and action, to allow readers to feel the conflict, not just think about it. Sort of like how I created my role play, so the therapists could feel the group process, not just think about it.

How do you, as a writer, help readers feel your work?